Tried And True Attorneys Standing Up For The Injured Since 1965


Tried And True Attorneys Standing Up For The Injured Since 1965

  1. Home
  2.  » 
  3. Workers' Compensation
  4.  » Top reasons why workers’ compensation claims are denied

Top reasons why workers’ compensation claims are denied

On Behalf of | Feb 17, 2023 | Workers' Compensation |

A workplace injury or illness is never expected. Therefore, it can throw your life into disarray, leaving you uncertain about your future and where to turn for help. But as you try to focus your efforts on your recovery and getting back to work, you might be able to secure some financial assistance through the workers’ compensations system. If you’re successful in pursuing one of these claims, then you may be able to recover periodic payments that will give you the financial stability necessary in your time of need.

While the workers’ compensation system can be enormously helpful to you, there’s no guarantee that you’ll be awarded benefits. In fact, a lot of people end up seeing their claims denied. If you want to avoid that from happening to you, then you should learn more about some common reasons for workers’ compensation denials so that you’re better equipped to anticipate and argue against them.

Top reasons why workers’ compensation claims are denied

There are a variety of reasons why a workers’ compensation claim may be denied. Amongst them are the following:

  • Your injury or illness isn’t work-related: Remember, in order to recover workers’ compensation benefits, you have to be able to demonstrate that your injury or illness was either suffered at work or was exacerbated by your work activities. If it appears from the evidence that your condition was suffered outside of work, then you’ll likely be denied benefits.
  • Inadequate notice to your employer: Once you’re injured in the workplace, you’re required to notify your employer within a specified period of time. This allows your employer to investigate the matter to determine how your injuries were caused. If you don’t provide adequate notice, then you’re claim will be denied.
  • You didn’t receive proper medical treatment: Workers’ compensation benefits are only going to be paid to you if you can show that your injury or illness prevents you from working. Your employer’s workers’ compensation insurer isn’t going to take your word for it on that point. Instead, they’re going to want to see medical documentation that indicates the severity of your injuries. Therefore, before you move forward with your claim, you need to ensure that you’re seeking out appropriate medical treatment.
  • Your injury was caused by roughhousing: Even if your injury was suffered at work, your claim may be denied if it was caused by your own horseplay or roughhousing at work. So, as you prepare your claim, you’ll want to consider your own actions leading up to the incident so that you can try to minimize any arguments that you’re responsible for your own injuries.
  • You were under the influence at the time of your workplace accident: If you were under the influence of drugs or alcohol at the time you suffered your workplace injuries, then you’re claim will be denied. This is why many employers ask for testing to occur after an accident.

Prepare your claim to address these reasons for a potential denial

As you can see, there are a lot of ways that your employer can try to get around paying you what you deserve. Don’t fall into those traps. Instead, be as fully prepared as possible to argue why you’re entitled to workers’ compensation benefits.

You may find that difficult to do if you’re unaccustomed to dealing with the applicable laws, which most people are. But that’s why you may find it helpful to seek out assistance from an attorney who is adept at navigating the workers’ compensation process. This may include seeking to appeal a claim denial. With a strong legal ally on your side, you might be able to obtain the outcome that you need to spur your recovery forward.